Provider Demographics
NPI:1508017039
Name:HAWS, DANIEL T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:HAWS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 LINDER STE 101
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634
Mailing Address - Country:US
Mailing Address - Phone:208-922-4149
Mailing Address - Fax:208-922-4140
Practice Address - Street 1:521 E ELDER ST
Practice Address - Street 2:SUITE #203
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3081
Practice Address - Country:US
Practice Address - Phone:760-728-1592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-45841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice